(SACRAMENTO) – The California Chronic Care Coalition (CCCC) today sounded the alarm on the health insurance industry’s practice of inappropriately denying patients the medicines, treatments and testing prescribed by their doctors. In their research study, “Standing Up For Your Rights Creates Results,” the California-based nonprofit found that the California Department of Managed Health Care (DMHC) reversed or overturned more than 60 percent of health plan decisions as part of the Independent Medical Review (IMR) process in 2017.

“The high percentage of cases that the DMHC reversed or overturned should raise red flags with consumers and policymakers alike,” said Liz Helms, president and CEO of CCCC. “It’s unacceptable that more than 60 percent of patients were inappropriately denied care because the health plan industry is trying to minimize costs.”

After a patient receives a denial for a service, medicine or treatment from their health plan, they can appeal the decision with their plan directly. Should the health plan deny the service a second time, patients have the right to request an IMR through the DMHC. An IMR is an independent review of a denied, delayed or modified health care service that the health plan has deemed to be not medically necessary, experimental/investigational or non-emergent/urgent.

“If these denials were only overturned because of the IMR process, think of the hundreds of thousands of Californians denied necessary care who never appealed the decision because they didn’t even know it was an option,” said Joan Werblun, RN, chair of CCCC. “It’s imperative that people living with chronic diseases and conditions, and all patients for that matter, know that they have the right to an appeal and they are not alone in their struggle to get the care they need.”

In 2017, the DMHC assessed $8,907,000i in fines and penalties against health plans, with Anthem Blue Cross being one of the major violators. In November 2017, DMHC took enforcement action against Anthem Blue Cross for its systemic violations of the grievance system, fining it $5 million for failing to identify, process and resolve consumer grievances in a timely manner. The $5 million fine was the result of 245 specific grievance system violations that occurred from 2013 through 2016. In each of these cases, Anthem deprived patients of their right to medical care.

While compiling the data necessary for “Standing Up For Your Rights Creates Results,” CCCC was alarmed at the number of individual denials requesting authorization or reimbursement of medications, procedures and testing. To evaluate the types and patterns of denials, CCCC took a closer look at 1,011 of more than 4,000 IMR cases, focusing on chronic conditions and serious illnesses such as cancer, mental health, musculoskeletal, cardiovascular and hepatitis. Those within these categories were denied requests which were vital for the effective treatment and management of their conditions. Although more than 50 percent of health plan decisions from this specific subset were reversed or overturned, it’s important to note the specific diseases and services that had higher counts of denials as it highlights the health plan industry’s routine practice of inappropriately denying care to patients in need.

In one such case, a young patient with juvenile spondyloarthritis was denied coverage of intravenous Remicade infusions as their health plan didn’t find it medically necessary. Before requesting Remicade, the patient had tried three other medications that failed to treat her inflammatory arthritis. To prevent long-term damage from leaving it untreated, the patient’s physician recommended Remicade infusions as the treatment is safe in the pediatric population and demonstrated significant improvement in arthritis, inflammatory markers, pain and physical function for juvenile spondyloarthritis. The independent reviewer determined the requested services were medically necessary and overturned the health plan’s denial.

Patients who need assistance navigating the complex health care system should visit My Patient Rights, a one-stop–shop created by CCCC to help patients receive the care they need and deserve. My Patient Rights provides information on how to file a complaint with a patient’s health plan, as well as the appropriate state agency. In addition, the website offers patients an avenue to learn about their rights and specific barriers put in place by health plans that may jeopardize their care.

About the California Chronic Care CoalitionThe California Chronic Care Coalition (CCCC) is a unique alliance of more than 30 leading health organizations and provider groups that promote the collaborative work of policy makers, industry leaders, providers and consumers to improve the health of Californians with chronic conditions. We envision a system of care that is accessible, affordable and of a high quality that emphasizes prevention, coordinated care, and the patient’s wellness and longevity. http://www.californiachroniccare.org

Posted: Feb 12, 2019 | Posted by Kassy Perry | Comments Off on We Stand With Seniors Applauds Governor Newsom for Prioritizing the Needs of California’s Aging Population in State of the State Address

Newsom includes development of a statewide Master Plan for Aging among his top initiatives

(SACRAMENTO) – We Stand With Seniors, the nonprofit, nonpartisan effort focused on educating state leaders about the need for a statewide, comprehensive Master Plan for Aging, commends Governor Gavin Newsom for being the first governor in recent history to address California’s aging population and the associated socioeconomic challenges.

“Let’s talk about something we too often overlook. The Golden State is getting grayer. We need to get ready for a major demographic challenge headed our way. For the first time in history, older Californians will outnumber young children. Over the next decade, our statewide senior population will increase by 4 million. In 25 years, it will double. And more than half will require some form of long-term care… It is time for a new Master Plan on Aging. We’ve deferred it for far too long. It must address person-centered care, the patchwork of public services, social isolation, bed-locked seniors in need of transportation, the nursing shortage and demand for In-Home Supportive Services that far outpaces its capacity.”
– Governor Gavin Newsom, 2019 State of the State Address

“Governor Newsom today showed he will truly stand with seniors by making good on a campaign promise to develop and implement a comprehensive and long-term plan that addresses the important healthcare, social and caregiving needs of the state’s growing population of older adults,” said Shelley Lyford, president and CEO West Health. “We look forward to immediately working with the governor and his administration on the development of this Master Plan for Aging and making successful aging a reality for all California seniors.”

In 2018, nonprofits West Health and The SCAN Foundation launched the nonpartisan, public awareness and education campaign, We Stand With Seniors, to educate policymakers about the need for a statewide, comprehensive Master Plan for Aging to address the challenges associated with the state’s rapidly aging population.

“For too long, the needs of California’s older adults, families and caregivers have been compromised by California’s scattershot approach of fragmented services,” said Bruce Chernof, president and CEO of The SCAN Foundation. “We view Governor Newsom’s commitment in today’s State of the State address as a catalyst for the state to undergo significant policy planning and changes so that older Californians can truly live with dignity and independence.”

The governor’s announcement, coupled with legislation introduced last week by Senator Hannah-Beth Jackson (D-Santa Barbara), is critical to addressing the care and support service needs of older Californians.

“I was pleased to see Governor Newsom recognize the issues facing California’s older adults in his State of the State today,” said Senator Hannah-Beth Jackson (D-Santa Barbara). “I look forward to working with him on a Master Plan for Aging through my Senate Bill 228 to address these challenges in a thoughtful and collaborative way. California must not leave our aging loved ones behind.”

About We Stand With SeniorsWest Health and The SCAN Foundation’s We Stand With Seniors… Will You? nonpartisan, public awareness and education campaign focuses on the specific challenges seniors and their families face in accessing high-quality, affordable healthcare, dental care and supportive services and the cost to the state if these challenges are not addressed. Keep up with #StandWithSeniors by visiting www.WeStandWithSeniors.org and following on Facebook @WeStandWithSeniors and Twitter @WeStandWSeniors.

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(SACRAMENTO) – We Stand With Seniors and the Assembly Aging and Long-Term Care Committee, in partnership with West Health, The SCAN Foundation, Archstone Foundation, Sutter Health, UDW Home Care Union and AARP California, will host Lives Well Lived: A Capitol Screening and Policy Discussion on Aging in California on February 5, 2019 at the Crest Theater in Sacramento. Co-hosted by Alzheimer’s Association, California Asian Pacific Islander Legislative Caucus, California Commission on Aging, California Legislative Women’s Caucus, LeadingAge California and Openhouse, the film screening and accompanying panel discussion will highlight the value of California’s older adults and the need for a state Master Plan for Aging.

“ʽLives Well Lived’ is a tribute to seniors who are defying the many negative stereotypes associated with growing older by living vibrant, productive lives and serving as inspirational role models for all of us to emulate,” said Shelley Lyford, president and CEO of West Health. “Californians deserve the kind of transformational policy changes from our leadership in Sacramento and a comprehensive plan that will enable every adult to successfully age with dignity, quality of life and independence.”

Lives Well Lived: Celebrating the Secrets, Wit & Wisdom of Age – a critically-acclaimed documentary film by Sky Bergman that celebrates the incredible lives of adults, ages 75 to 100, who are living their lives to the fullest – will be presented via a screening for Governor Gavin Newsom and his appointees, constitutional officers, legislators, aging advocates and the media.

“This film is a powerful statement for empowering our state’s older adults, families and caregivers – as well as marginalized communities,” said Bruce Chernof, MD, FACP, president and CEO of The SCAN Foundation. “Through a statewide, comprehensive Master Plan for Aging, California has an extraordinary opportunity to lead the nation in providing its aging population cost-effective, high-quality health and supportive services.”

Moderated by State Treasurer Fiona Ma, the panel discussion will focus on how a Master Plan for Aging in California will help address and solve the myriad challenges currently faced by the state’s diverse and rapidly aging population. Panelists include Assemblymember Adrin Nazarian, Chair of the Assembly Aging and Long-Term Care Committee; Shelley Lyford, West Health; Bruce Chernof, MD, FACP, The SCAN Foundation and Zach Gassoumis, PhD, University of Southern California’s (USC) Leonard Davis School of Gerontology.

Other speakers include Sky Bergman, Director of Lives Well Lived, Assemblymember Ash Kalra and Nina Weiler-Harwell, AARP California. For more information on partners and co-hosts, as well as tickets to Lives Well Lived: A Capitol Screening and Policy Discussion on Aging in California, visit www.WeStandWithSeniors.org/Lives-Well-Lived.

About We Stand With SeniorsWest Health and The SCAN Foundation’s We Stand With Seniors… Will You? nonpartisan, public awareness and education campaign focuses on the specific challenges seniors and their families face in accessing high-quality, affordable healthcare, dental care and supportive services and the cost to the state if these challenges are not addressed. Keep up with #StandWithSeniors by visiting www.WeStandWithSeniors.org and following on Facebook @WeStandWithSeniors and Twitter @WeStandWSeniors.

About Lives Well Lived: Celebrating the Secrets, Wit & Wisdom of AgeThe documentary film by Sky Bergman includes heartfelt interviews with forty older adults, encompassing over 3,000 years of life experience, who share their secrets and insights to living a meaningful life. Their intimate memories and inspiring personal histories entertain and inspire, while reminding us that older adults are, and should be, a valued part of our society. Watch the trailer at www.Lives-Well-Lived.com.

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Malnutrition in older adults is becoming a crisis in America – not just California

California – and indeed the nation – faces a crisis that has loomed on the horizon for years while the state has refused to prepare.

The crisis I’m alluding to is the state’s rapidly aging population. California will have an estimated additional 4 million seniors by 2030. The Public Policy Institute of California anticipates that this trend will continue for decades.

Fortunately, during election season, Gov. Gavin Newsom committed to creating a statewide master plan for aging to address the increased demand for health, food assistance and supportive services. In his Jan. 7 inauguration speech, Newsom spoke of the need to ensure seniors’ ability to retire with security and live at home with dignity.

Although it’s a large step in the right direction, the people of California need more than a commitment. As the aging demographic continues to grow, the stress on the state budget will significantly increase. To meet demand and provide needed care, Newsom must prioritize resources and follow through.

The plan should identify and address the social factors that place seniors at risk for malnutrition and other diseases. Feeding America’s “2016 State of Senior Hunger in America” reports that 1,060,304 seniors are threatened by hunger in California.

The plan should also expand home- and community-based services to ensure older adults can access proper nutrition and other supportive services they need to stay healthy and to prevent costly health complications. The United Health Foundation’s “America’s Health Rankings 2018 Senior Report” states that 36 percent of hospitalizations that are due to inadequate nutrition and/or limited social contact are preventable.

While it might be difficult to comprehend in a state of such abundance, California leads the nation in the percentage of older adults living in poverty. Consequently, access to nutritious meals will be severely limited without assistance.

Although it’s often not identified or treated, malnutrition in older adults severely impacts their ability to fight illness and infection and can result in higher mortality rates and loss of independence. As the population ages, malnutrition in older adults is becoming a crisis in America – not just California. In fact, estimates are that the federal government pays a staggering $157 billion to treat older adults’ diseases associated with malnutrition.

This master plan should also connect state departments and funding streams, and include a coordinated framework between nutrition, long-term care, transportation, housing and other support services. In other words, we must work together.

In 1977, former Vice President Hubert Humphrey said that one moral test for government is how it treats “those who are in the twilight of life, the elderly.” In order to meet that test, the new administration must develop, create and execute a master plan for aging that allows those in the “twilight of life” to enjoy good health and age with dignity, choice and independence.

Susannah Meyer is Community Engagement Director at Meals on Wheels Diablo Region.

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In his inauguration speech, Gov. Gavin Newsom pledged that “every senior should be able to retire with security.” That’s a significant commitment to address challenges facing older adults, families and caregivers who struggle in a dysfunctional system.

California has an insufficient system of long-term services and supports for older people and people with disabilities, as detailed in a 2015 report by the California Senate’s Select Committee on Aging and Long-Term Care.

The report painted an alarming picture of the shortcomings of the current system, but offered real solutions: California can build a better system to serve all who have long-term care needs.

Since the Senate issued its report, the problem is only becoming more critical. By 2030, the California Department of Finance projects 24 percent of the population will be at least 65. And, in the next 20 years, the number of adults with disabilities could grow by 20 percent.

This added pressure on the system is creating a crisis for the middle class and generational poverty as each generation spends more of its savings caring for family members.

According to an AARP study, the annual cost of nursing homes is more than double the $50,000 median income of older households in California. Although Medi-Cal is a major public payer for the system of long-term services and supports, the high cost of nursing homes and long-term services is causing an increase in the number of unpaid family caregivers. The study also showed that in 2013, 4.5 million family caregivers provided care valued at roughly $58 billion.

Fortunately, there are innovative ways to address the long-term care crisis to achieve the intended results without putting additional pressure on the state’s general fund.

While some people can afford private long-term care insurance, the market for those policies is disappearing. As premiums rise, insurance companies are dropping coverage for long-term care.

And, as most people find out when it is too late, Medicare does not adequately cover long-term care services, which are far too expensive for most to pay out of pocket.

What is desperately needed is a solution that fits the diverse long-term care needs of the Golden State. We need an affordable and accessible system of long-term care for all Californians, regardless of their income or ZIP code.

To come up with that solution 20 organizations representing long-term care stakeholders have come together to form the California Aging and Disability Alliance. This alliance is working on an innovative and cost-effective approach to the long-term services and supports challenges we face.

We believe the public would embrace funding a limited but meaningful range of services for those with long-term services and supports needs. This would have many positive effects, including providing some relief to the state in its Medi-Cal long-term services and supports costs.

In the next few months, California Aging and Disability Alliance will develop our proposal based on that principle and seek the active involvement of the Legislature. At the same time, we look forward to working closely with Gov. Newsom to support his ideas and plans on this issue.

As Gov. Newsom said: “I have never been a fan of pretense or procrastination. After all, our state is defined by its independent, outspoken spirit.”

We agree. California can do this, but only if we work together.

Nancy McPherson is state director for AARP California, nmcpherson@aarp.org. April Verrett, aprilv@seiu2015.org, is President of SEIU Local 2015, both are CADA members. They wrote this commentary for CALmatters.

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Posted: Jan 24, 2019 | Posted by Kassy Perry | Comments Off on Remote Participation Enables Patients With Alk-Positive Lung Cancer From Across The Country To Participate In New Study of Treatment Resistance

SAN CARLOS, CA — The Addario Lung Cancer Medical Institute (ALCMI), a patient-founded not-for-profit global research consortium, and researchers from the Dana-Farber Cancer Institute are launching a novel nationwide study to understand why treatment resistance develops in a specific group of lung cancer patients.

The Study of Plasma Next Generation Sequencing for Remote Assessment, Characterization, Evaluation of Patients with ALK Drug Resistance [SPACEWALK] uses the latest gene-sequencing technology on blood plasma of patients with a rare form of lung cancer. This type of lung cancer is defined by a mutation in a gene called anaplastic lymphoma kinase (ALK), which is present in about 5 percent of patients with non-small cell lung cancer (NSCLC). Although ALK-positive lung cancer makes up only a small percentage of all lung cancers, with more than 234,000 new cases of lung cancer expected in 2018, it is likely that up to 10,000 of those will be ALK-positive.

Most, but not all, patients with ALK-positive lung cancers benefit from targeted treatment with oral therapies directed at ALK. There are now five FDA-approved ALK inhibitors. Treatment can work for months or years before resistance develops and lung cancer begins growing again. Resistance can be caused by new mutations in the ALK gene, and some of these resistance mutations can be effectively targeted by switching to another ALK inhibitor. The SPACEWALK study seeks to better understand the molecular causes of drug resistance to help doctors determine if switching to a different ALK inhibitor could prove beneficial.

“I’m sure you can imagine how hard it is on patients and families to hear that a treatment has stopped working,” said Gina Hollenbeck, a stage IV cancer survivor. Hollenbeck is the president of ALK Positive, an international support group of patients with ALK-positive lung cancer and their caregivers who take an active role in raising awareness of research opportunities. “We’re very excited to see a nationwide study that can expand our understanding of treatment resistance and how to overcome it.”

Advances in gene-sequencing now allow doctors to understand a tumor’s genetic composition from a sample of a patient’s blood, sometimes called a “liquid biopsy.” In the past, genomic analysis required patients to undergo an invasive biopsy to collect tumor tissue for testing. With a liquid biopsy, doctors can analyze tumor DNA shed into the bloodstream, which means patients only need to go through a simple blood test. By using liquid biopsies, with blood samples shipped for analysis, the study enables patients across the country to participate. A study open to patients throughout the U.S. is especially important in conducting a meaningful study of uncommon conditions.

“As we gain more treatment options for ALK-positive lung cancer, we now need better diagnostic tools to help us choose the best treatment for each patient,” said Geoffrey R. Oxnard, M.D., the study’s principal investigator and a medical oncologist at Dana-Farber Cancer Institute who specializes in research and treatment of non-small cell lung cancer. “We are so excited to offer a research study across the U.S. that both allows these patients to participate in research toward understanding drug resistance, while also giving them a test result that could help guide them to a new treatment option.”

“These are exciting times in lung cancer research,” said Bonnie J. Addario, 14-year lung cancer survivor and ALCMI founder. “Learning more about the genetic composition of cancer tumors can unlock doors to new and better treatments. We’re pleased to play a part in advancing this promising path toward turning lung cancer into a well-managed condition.”

About the Addario Lung Cancer Medical Institute The Addario Lung Cancer Medical Institute (ALCMI, voiced as “Alchemy”), founded in 2008 as a 501c(3) non-profit organization by lung cancer survivor Bonnie J Addario, is a patient-centric, international research consortium driving research otherwise not possible. Working in tandem with its “partner” foundation, the Bonnie J. Addario Lung Cancer Foundation (ALCF), ALCMI powers collaborative initiatives in genetic (molecular) testing, therapeutic discoveries, targeted treatments and early detection. ALCMI overcomes barriers to collaboration via a world-class team of investigators from 26 member institutions in the USA, UK, and Europe. ALCMI combines scientific expertise found at leading academic institutions with patient access through its network of community cancer centers to accelerate research.

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Sacramento, Calif. – My Patient Rights and the California Chronic Care Coalition are reminding Californians to make sure that they and their family members are aware of a new law that takes another step in addressing the opioid crisis. This law states that prescribers of pain-relieving opioids must also offer a prescription for the opioid-overdose reversal drug, naloxone, to high-risk patients. AB 2760 was passed overwhelmingly by the California Legislature and signed into law in September 2018 by Gov. Edmund G. Brown, Jr.

This problem has become so acute that the U.S. Surgeon General issued its first advisory in 13 years recommending emergency treatments like naloxone – which is so important to saving lives – be available for consumer use.

“For patients with chronic illness, pain relieving opioids are a lifeline but the risk of an overdose increases the more you take to combat the pain,” said Liz Helms, president and CEO of the California Chronic Care Coalition. “Requiring naloxone to be offered at the same time as prescribing an opioid pain medication will go a long way in preventing accidental overdoses and needless deaths. And since many caregivers are family members, it is important to make them aware that this potentially life-saving emergency treatment will be more readily available when opioids are prescribed.”

“Naloxone is a tool that can immediately save lives. And I hope this new law will provide an opportunity for discussion of the potential for accidental opioid overdose and how to prevent it,” said Assemblymember Jim Wood (D-Santa Rosa), author of AB 2760.

Anyone who uses opioids for pain control is at risk for an opioid overdose emergency. Now that naloxone co-prescription for high risk individuals is the law in California, make sure you and your families are prepared for the unexpected by talking about opioids, the potential for overdose even when used correctly, having naloxone with you, and recognizing the signs of overdose:

Slow or shallow breathing

Slowed heartbeat and weak pulse

A loss of consciousness

Pale, blue or cold skin

Knowing the risks, recognizing the signs and having naloxone on-hand will go a long way in potentially saving a life from accidental opioid overdose.

About My Patient Rights and the California Chronic Care CoalitionMy Patient Rights was launched by the California Chronic Care Coalition to help people who have been denied treatment or medicines, experienced delays or are dissatisfied with the decisions made by their health plan.

The California Chronic Care Coalition (CCCC) is a unique alliance of more than thirty leading consumer health organizations and provider groups that engage policy makers, industry leaders, providers and consumers to improve the health of Californians with chronic conditions. We envision a system of care that is accessible, affordable and of a high quality that emphasizes prevention, coordinated care and the patient’s wellness and longevity.

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Two years ago, at the age of 55, Terri Ann DiJulio was diagnosed with lung cancer—for the second time.

Ms. DiJulio says she was devastated. In the 12 years since her previous bout with cancer, her mother had died from lung cancer and two of her mother’s siblings were still fighting the disease.

Nonetheless, Ms. DiJulio says she was struck by how much had changed in the intervening years, not only for her but also for her family. There were better methods of early detection, more treatments and greater recognition that many people who get cancer, like her mother, never smoked.

During her first lung cancer, Ms. DiJulio had the right lower lobe of her lung removed. This time, the oncologist told her, there was a new method of radiation that would let her avoid a painful surgery and spare the rest of her lung. The approach let Ms. DiJulio, who is an avid bike rider, get back to cycling. In September, she rode 260 miles to raise $10,100 for the Bonnie J. Addario Lung Cancer Foundation.

“I had better options than my mother,” says Ms. DiJulio. “But I want the next generation after me to have better options than I do.”

Tuesday’s report by investigators at the American Cancer Society showed good news in the fight against cancer, with overall cancer mortality rates steadily declining over a 25-year period. The researchers estimated that, mainly due to people stopping smoking and earlier detection methods for many cancers, there were an estimated 2.6 million fewer cancer deaths from 1991 to 2016. There are also growing numbers of new drug treatments for lung cancer, including Merck & Co.’s Keytruda, which was approved by the Food and Drug Administration in 2015 to treat a form of lung cancer.

Still, 25% of all cancer deaths are due to lung cancer, and more people die from lung cancer than breast, prostate and colorectal cancer combined, says Rebecca Siegel, lead author of the American Cancer Society’s report. “We have made great progress,” says Ms. Siegel, the strategic director of surveillance information services at the American Cancer Society. “But the number of deaths from lung cancer is still shocking.”

Ms. DiJulio says her family’s story illustrates some of the ways things have gotten better, along with the many challenges that remain.

Her first lung cancer was found accidentally. Ms. DiJulio says she felt pressure in her chest so her doctor sent her to the hospital, concerned about a possible heart problem. Instead, scans turned up a nodule on her lung. Doctors said they weren’t sure if it was cancer and advised that she be closely monitored with regular scans. Ms. DiJulio, who had smoked around five cigarettes a day from the time she was 17, quit smoking.

Two years later, doctors said the scans revealed the nodule was growing, so Ms. DiJulio underwent surgery. “I woke up without the lower right lobe of my lung,” she said.

Eighteen months after Ms. DiJulio’s surgery, her mother, who never smoked, was also diagnosed with lung cancer. Ms. DiJulio’s mother felt pressure in her chest and went to the hospital thinking she was having a heart attack. She died in 2011 at the age of 79.

After Ms. DiJulio’s mother was diagnosed, doctors recommended that close family members receive screening using low-dose computed tomography. The screening found lung cancer in Ms. DiJulio’s aunt and uncle, who had no symptoms of disease. The disease was caught early, Ms. DiJulio says. They are both still alive; Ms. DiJulio’s aunt is now involved in a clinical trial involving Keytruda in patients who have a recurrence of lung cancer.

According to the American Cancer Society report, lung-cancer screening has potential to identify tumors much earlier and has been shown to reduce cancer mortality by 20% in current or former smokers with a history of smoking the equivalent of two packs a day for 15 years or more. But many people, including Ms. DiJulio and members of her family, wouldn’t have qualified for screening under those guidelines.

Ms. Siegel says there are still challenges with making screening available to a wider population because the equipment is expensive, and it requires a prior conversation with a physician explaining risks and benefits.

Bonnie Addario, a 14-year lung-cancer survivor and chair of the foundation, says there is a need for more drugs, including targeted therapies. The foundation supports research into an inherited gene found in some lung-cancer patients and the development of early-detection screening methods for family members of lung-cancer patients.

Recently, Ms. DiJulio and her family members started discussing participating in a familial genetics research study. She thinks more personalized treatments may be the best hope, not only in her family’s long-running odyssey with lung cancer, but for improving mortality rates in the coming 25 years, too.

“I have a 20-year-old beautiful and vibrant niece, and I think about her,” says Ms. DiJulio. “My family has benefited from the advances, but we need to do more.”

Now that the Democrats have taken the Speaker’s gavel in the House, the media is filled with predictions from the pundit class as to what will happen. They don’t know any more than you and me but when you need to fill 24 hour cable news this is what passes for informed political commentary.

Here in California the Democrats have tightened their grip on state government to the point that Republicans hold no statewide offices and in the state legislature they barely have enough members to serve on committees.

The once dynamic Republican Party in California that gave us Ronald Reagan and regularly could be counted on to deliver its large haul of Electoral College votes to Republican presidential candidates, is on life support and in danger of becoming as extinct as the dinosaurs.

While the media write the obituaries on the California Republican Party, some Republicans are writing newspaper columns opining on what needs to be done to resuscitate the party and make it viable again.

Mind you the ones writing all these columns are the same ones who are responsible for its demise. That’s like having the autopsy performed by the same doctors who killed the patient.

They want to hire consultants to analyze the data from the last election and convene focus groups to find out why they lost and why their party is shrinking to the point they are outnumbered by voters who decline to state party preference.

And more importantly, they blame President Trump for all their electoral woes conveniently forgetting that their party’s political health has been declining long before Donald Trump arrived on the scene.

But politics isn’t just about analyzing data and folks ain’t lab rats to be viewed by consultants behind one-way glass in a focus group.

Politics is visceral and comes from the gut and the heart- something Democrats have known and been using effectively for years.

Trump tapped into that in a way they never have and never could. The Never Trump GOP consultants in California have been exposed as frauds that have been selling the same snake oil to the Republican faithful for years and losing elections.

California Republicans don’t stand for anything. They have no real message or messengers who can deliver it if there was one.

Led by Arnold Schwarzenegger, squishy Never Trump Republicans have come up with something called New Way California which is nothing more than a diet cola version of Democrats.

Arnold and his crew say Republicans need to be open to compromise.

What makes him think Democrats want to compromise? Why should they?

Democrat’s idea of compromise is like the old Soviet Union’s idea of compromising on nuclear weapons during the Cold War. “What’s mine is mine. What’s yours we’ll compromise.”

The New Way crowd says nothing about cutting back on California’s bloated government and the army of bureaucrats whose future pensions will eventually bankrupt the state.

And by the way when he was Governor what did Arnold do to help build a better Republican Party?

Not a damn thing. In fact he proved the only thing he cared about was saving his own skin for re-election in 2006 when he joined forces with Democrats and signed AB 32 sucking up to the climate change crowd.

He now travels the world in his private jet telling the rest of us to drive electric cars while he burns carbon by the ton.

The California Republican Party will never rise from the ashes by listening to Arnold Schwarzenegger and his band of elitists who think they know best.

Nor will they become relevant again by emulating the Republican Party in more conservative regions of the country.

Republicans must return to becoming a party of Westerners.

Since the days of the pioneers Westerners have traditionally distrusted big government like the kind California now has.

Republicans need to preach self-reliance as the key to opportunity.

Republicans need to understand that playing catch-up on identity politics and surrendering to the lazy tired analysis that “demographics is destiny” is no substitute for putting more money in everyone’s pocket.

Republicans need to remind folks that with rights comes responsibility and people are free to do as they please as long as it ain’t illegal and don’t scare the horses.

Republicans will need to articulate policies that will grow the base of middle class voters not simply replace the ones who are voting with their feet and leaving California.

Republicans will need to tell every hard working Californian regardless of race, creed, color or sexual orientation that there ain’t enough money to pay for all the grandiose plans of the Democrats.

Even if they taxed rich folks 100% there ain’t enough of them to pay for their schemes either.

Republicans should warn all Californians that eventually-when they have squeezed all they dare out of those same rich folks-Democrats will come for them and bleed them of all their hard earned money.

And since middle income voters believed they were exempt when Democrats said they were only going to soak the rich with tax hikes, nobody will be left to speak for them when their taxes are inevitably raised.

When Adolf Hitler was rising to power in Germany in the 1930s, Winston Churchill was in the political wilderness having lost his position in the government. He seemed out of touch to some and many wrote his political obituary-much like California Republicans today.

He returned to Parliament as a back bencher with no real power. And it was there Churchill became a lone voice warning his countrymen that Herr Hitler had bad intentions and they must be prepared for another war.

History shows that Churchill was right and when war did come, his country turned to him to lead them to victory.

California Republicans need to be like Churchill warning their fellow citizens of the coming fiscal storm.

At every opportunity when Democrats propose new spending they should ask where is the money coming from?

They should remind their fellow Californians that nothing is free no matter what the Democrats say.

And when the bills come due for the spendthrift ways of the Democrats at least they can say…We told you so.

Turlock and its surrounding communities need to address our growing homeless population. The needs are great, and the challenge is significant, but not impossible.

No one wants to be homeless, cold or sick. Many homeless individuals are women and men who got lost in a depersonalized healthcare and mental health system; people whose lives changed when the economy took a dive and they lost their jobs. Others became part of a drug culture that has and continues to devastate their lives and the lives of their families and friends. Turlock has a handful of nonprofit organizations that have taken the lead in addressing the needs of the homeless. The City of Turlock has offered its assistance, too. The core of the problem? There is no plan.

No single nonprofit agency or government agency has taken the lead in developing and implementing a strategy. Without a leader and a strategy, discussions continue to be circular, frustrations of downtown business owners grow, community members continue to raise safety concerns and homeless women and men do not know where to turn. Acting without research wastes resources and time that the homeless and the members of our community do not have to spare. Our success as a community will be insured by our ability to integrate long-term and short-term planning and to maximize available funding and services.

What is in place?

We Care provides nighttime shelter for homeless men and housing solutions. The Turlock Gospel Mission has focused on caring for homeless women and families. The Salvation Army is taking care of whoever walks through their door. United Samaritans Foundation feeds people lunch, provides showers, outreach and food boxes; and the Turlock Gospel Mission offers free breakfast and perhaps additional meals. Haven Women’s Center provides care for homeless domestic abuse survivors and their children. Prodigal Sons and Daughters focuses on teenagers who may be homeless, using drugs or alcohol and treating adults for their addictions.

These are all functioning organizations that are providing worthwhile services. Our community and the community’s homeless individuals, need them all. However, let’s look for a moment beyond the homeless community’s basic needs for food, shelter and safety. Are there training programs that some homeless individuals may qualify for? Are there housing programs to begin to help bring a sense of normality to the lives of homeless women, children, families and men? What is the role of Stanislaus County, and what have they done to help Turlock?

The questions are endless. The frustrations continue to mount across government, business, nonprofits and those legitimately in need. Compounding these problems is the need for access to medical care and mental health services.

While each of these steps is important and valuable, no one has stepped forward to take ownership of the issue and build a strategy to address the multiple problems faced by various stakeholders (or take ownership). It’s a new year. Let’s begin 2019 with a plan called, “Building A Better Turlock” which is outlined, below.

Step One: Who is Serving the Homeless?

If the Mayor and City Council want our help, Legacy Health Endowment wants to step up. To begin, we will lead an effort to survey the major programs serving the homeless. The survey will consider the services provided, the fundraising needs, the gaps in care and a recommended path forward. The survey would be transparent by working with a handful of leaders of homeless programs, the City, the Turlock Journal Editor and downtown business owners. This would help ensure that we are focusing on the issues that matter, the questions and answers that are being raised and considered and conclusions about how best to address the challenges we face.

Step Two: Addressing the Health and Mental Health Needs of the Homeless

Recently, Legacy Health Endowment provided funding to the Castle Family Health Center and UCSF Fresno School of Medicine to launch a mobile healthcare clinic. Physician residents from the UCSF Fresno program are providing physicals, flu shots and other primary care services to ensure that people who need healthcare services have access. The EMC Health Foundation has funded a full-time mental health clinician to work with the homeless to begin to understand the kinds of mental health issues involved. Throughout the next few months, we will report to the Mayor and City Council on whether, and to what extent, there is a healthcare crisis for the homeless, as well as how it is being addressed today and tomorrow.

Step Three: Articulating a Plan

In 60 days, LHE will present elected officials, business leaders, homeless advocates and the community with a report on our findings and very specific recommendations.

Step Four: Important Interim Steps

Throughout the next 60 days, we propose the following:

The Turlock Gospel Mission or United Samaritans utilize its meals programs and food bank to serve the homeless;

We urge the Salvation Army and the Turlock Gospel Mission Homeless Assistance Ministry (H.A.M. Day Center) to open their doors for people to a have a warm place to rest at night since We Care is usually at capacity these days. Imagine lining up cots on the gymnasium floor of the Salvation Army Building to offer a homeless individual a warm bed;

The City Executives, led by Maryn Pitt, (who is knowledgable and passionate about solving these problems locally) will work with the County to identify funds to help the Gospel Mission fund the operation of the warming center;

We Care to dedicate two beds in its shelter to provide shelter for homeless men being released from EMC Hospital, with Covenant Care at Home providing the follow up medical care for not more than 10 days to help get these men back on their feet and into the community;

Golden Valley Health Centers continue its mobile nurse program helping treat homeless women and men with immediate healthcare needs. The program has and continues to be a great success; and

It is long overdue to have a centralized food distribution strategy where individual nonprofits are not picking up the donated food and then being charged for it.

This is a 60-day plan. Not perfect, but a plan, nevertheless. It allows all the stakeholders in our community to participate and it promotes and embraces transparency as we begin to move forward. Once the report is finished, we will offer to present the findings to the Mayor, City Council, City Manager and staff.

There are no quick or easy solutions to addressing the needs of the homeless, but we can, we must, stop the finger pointing and build a solution. The need is great and the challenge enormous, but not impossible. My email is jeffrey@legacyhealthendowment.org — let me know if you want to ‘Help Build A Better Turlock.’

— Jeffrey Lewis is the President and CEO of Legacy Health Endowment. The views expressed are his own.